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Identification of post-menopausal women at risk of osteoporosis by trained general dental practitioners using panoramic radiographs

¹ Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan; ² Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; ³ Department of Clinical Radiology, Hiroshima University Hospital, Hiroshima, Japan; ⁴ Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; ⁵ Hiroshima Dental Association, Hiroshima, Japan

*Correspondence to: Dr Akira Taguchi, Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8553, Japan; Email: akiro{at}hiroshima-u.ac.jp

Received 26 April 2006; accepted 19 June 2006

Background: An eroded inferior cortex of the mandible on panoramic radiographs may be useful for identifying post-menopausal women with low bone mineral density (BMD), or osteoporosis. The purpose of this study was to assess whether trained general dental practitioners (GDPs) can identify post-menopausal women with undetected low skeletal BMD as well as spinal fractures by panoramic radiographs in their clinics.

Methods: Out of 455 women aged 50 years and older who visited the dental clinics of 22 trained GDPs and had panoramic radiographic assessment for the examination of dental diseases between June and December 2004, 168 post-menopausal women were diagnosed as having low skeletal BMD based on cortical erosion findings. Of these women, 39 women aged 50–84 years (mean age (SD, standard deviation), 64.8 (7.4) years) with no previous diagnosis of osteoporosis participated in this study. BMD at the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry (DXA). Spine fractures were assessed on lateral radiographs obtained at the time of the DXA assessment.

Results: Two women (5.1%) had normal BMD (BMD T-score>–1.0), 21 women (53.9%) had osteopenia (BMD T-score of –2.5 to –1.0) and 16 women (41.0%) had osteoporosis (BMD T-score<–2.5). Eight women (20.5%) had fractures at the thoracic spine, lumbar spine, or both.

Conclusions: Our results suggest that a high percentage of post-menopausal women with undetected low skeletal BMD as well as spinal fractures may be identified based on trained GDPs' analyses of their panoramic radiographs.

Keywords: osteoporosis; fracture; dentist; menopause; panoramic radiography

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